The primary long-term goal of this project is to develop a user-friendly, online all-hazards planning and site- specific training system with an information sharing framework with real-time data aggregation available for access by the long term care (LTC) facility, other LTC facilities and ancillary and cooperating agencies. The overall goal of REALPREP is improved outcomes at the LTC facilities during actual disaster preparedness plan execution and emergency response via better plans, improved training and greater information sharing. A 2005 survey revealed that only 10% of the nation's long-term health facilities had an emergency response plan. Additionally, an August 2006 report from the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) noted that all 20 of the facilities included in the report had major issues when attempting to implement disaster plans during Hurricane Katrina;3 Of the 1,330 deaths reported 71% of the victims were over age 60, and nearly half were older than 75.4 Such findings suggest that more attention need to be paid in supporting LTC facilities in developing effective and easily updatable plans.5 An "all- hazards" approach to disaster preparedness needs to take into consideration the fact that older adults are vul- nerable and at risk for physical and psychosocial problems during times of disaster or potential bio-terrorist threats.2 In addition, while limited emergency planning software exists, only one known application attempts to address the increased challenges of LTC facilities. Severe usability issues and a lack of intuitiveness, which forces in- terested LTC staff to invest time and money to use the resource has hindered its acceptance in the market. In this study, our research team proposes to develop a web-based tool called REALPREP (Real-time Emer- gency Application and Learning for Preparedness), which will promote active all-hazards preparedness plan- ning and site-specific training for the unique needs and issues facing LTC facilities. This fast actionable system enables LTC providers, managers, and staff-a number, which is projected to be 1.8 million--to plan and re- spond to bioterrorism threats, natural disasters, and other public health emergencies, with little or no prior training. REALPREP uses RIA and is modeled after TurboTax in its approach to guiding users with little or no background in the disaster preparedness subject matter in producing what it needs quickly, accurately and ef- fectively. Building on prior work on the PREPARE curriculum, the system automates disaster plan development using site-specific profile information integrated with ICS Concepts and best practices for LTC disaster plan- ning for all 15 DHS identified scenarios. A Phase I grant is expected to cover the costs of the prototype, an evaluation of its utility and the feasibility of custom training from the input. PUBLIC HEALTH RELEVANCE: REALPREP is the online all-hazards planning tool that can help LTC facilities to easily create, update and communicate the all-hazards plan to staff and emergency response agencies via an intuitive interface. The REALPREP system, based on user-centered design principles and previous award-winning PREPARE train- ing, will provide a solution which address the challenges (such as ongoing staffing shortages, high turnover, unique regulatory requirements, and vulnerabilities faced by older adults) facing LTCs in preparing staff for responding to all-types of public health hazards. Additionally, REALPREP can reduce the burden on LTC staff to maintain their all-hazards plans in a central secure repository.